While epilepsy is different for everyone, the majority of people with epilepsy are able to control their seizures with the help of medications or other treatments. Finding the right medication is a very individualized process, and may take trying several different seizure medications or a combination of medications to find which ones work best.
It is important to work with a neurologist if you are newly diagnosed. If you’re unable to gain seizure control through the use of medication, the next step is working with an epileptologist or visiting a comprehensive epilepsy center and exploring other options.
If your seizures are difficult to control, meaning you continue to have seizures after one year or after two anti-seizure medications have been tried, we recommend seeking more specialized care.
Epilepsy centers provide a team approach to caring for people with seizures and epilepsy. Testing is available to diagnose whether a person has seizures and the type of epilepsy they may have. Epilepsy experts can help explore all treatment options, including new or add-on seizure medications, surgery, devices, dietary therapy, or a clinical trial.
Medication is the most common treatment for controlling seizures and is almost always the first therapy. Medicine controls seizures for about 7 out of 10 people living with epilepsy. There are many different anti-epileptic drugs (AEDs) and different medicines help with different kinds of epilepsy/seizures.
It is important to talk with your doctor about the pros and cons of the different AEDs and to never stop or change your medicine without talking to your doctor, as this could cause complications.
Epilepsy surgery has been a treatment used to help control seizures for over 100 years. Improvements in modern methods have made epilepsy surgery safer and more available than ever before. A number of brain surgeries can treat certain kinds of seizures that cannot be controlled with medication or other forms of treatment. Some types of epilepsy surgery may lead to seizure freedom and an improved quality of life in up to 80% of people with drug resistant epilepsy.
Epilepsy surgery can be overwhelming to consider. Many people are unsure if surgery can help them, but surgery needs to be considered as an option for people whose seizures are not controlled with medications, dietary therapy, or implanted devices.
Dietary therapy is an approach to help control seizures, usually in conjunction with seizure medications. The classic ketogenic diet, a special high-fat, low-carbohydrate diet, is prescribed and monitored by a physician and nutritionist and can help control seizures in some people. It can help both children and adults with refractory seizures. Additionally, the Modified Atkins Diet (MAD), which has some similar components to the traditional ketogenic diet, can be effective.
Each diet is personalized for the individual and should be done under medical supervision.
Download this factsheet to learn about the 4 major types of dietary therapy used to treat epilepsy, including the ketogenic diet, Medium-chain triglyceride diet (MCT), Modified Atkins Diet (MAD), and Low Glycemic Index Treatment (LGIT).
Neuromodulation is another option for controlling seizures. This therapy involves using a device to send small electrical currents to the nervous system.
VNS Therapy® consists of a device that is implanted under the skin in the left chest area. An electrode or wire is attached to the generator device and placed under the skin. The wire is attached or wound around the vagus nerve in the neck. The device is programmed in the outpatient clinic to deliver pulses or stimulation at regular intervals. For some people this may help stop seizures. Learn more, or Download this factsheet to learn about VNS, how it works, and who can use it.
The RNS® System is similar to a heart pacemaker. It can monitor brain waves, then respond to activity that is different from usual or that looks like a seizure. A device or stimulator is placed in the skull. Tiny wires or leads are placed in one or two places on top of the brain where seizure activity may begin. These wires connect to the stimulator. Once the wires and device are placed, nothing can be seen.
The system can give small pulses or bursts of stimulation to the brain when anything unusual is detected. This can stop seizure activity before the actual seizure begins. Or it could stop seizure activity from spreading from a small focal seizure to a generalized seizure. Learn more, or Download this factsheet to learn about who can use RNS and how the device works.
The DBS device is placed by a neurosurgeon during an operation. Thin wires (called electrodes) carry electrical impulses from the neurostimulator device directly to the brain to stop brain signals that causes seizures. These electrical impulses help to stop seizures from beginning or spreading to different areas of the brain. Learn more.
Colorado is one of many states that allows medical use of cannabis. People living with uncontrolled seizures who have previously attempted other forms of treatment have reported beneficial effects and reduced seizure activity, especially with cannabidiol (CBD) oil. The Epilepsy Foundation of Colorado & Wyoming supports further research on CBD/medical marijuana. Anyone contemplating these options should conduct research to reach an informed treatment decision.
- Medical marijuana (also called medical cannabis) is whole plant marijuana or extracts from the plant used for medical purposes.
- Cannabinoids are substances in cannabis that act on cells in the body, including the brain. The two main cannabinoids used in medicine are tetrahydrocannabinol (THC) and cannabidiol (CBD).
- Evidence from laboratory studies, anecdotal reports, and small clinical studies over a number of years suggest that cannabidiol (CBD) could potentially help control seizures. The FDA recently approved the use of Epidiolex (a plant-based formulation of CBD) to treat seizures for people 2 years of age and older with Dravet syndrome and Lennox-Gastaut syndrome (LGS).
- Medical cannabis, CBD, and THC all have possible side effects. The most common side effects of CBD included sleepiness, diarrhea, fatigue, and decreased appetite.
- CBD also interacts with some other seizure medicines. Careful monitoring of CBD is needed.
- When conventional treatments do not work to control seizures, as is the case for roughly 30% of people with epilepsy, it is not unreasonable to consider CBD oil.
Learn about the Epilepsy Foundation’s state and federal advocacy efforts on removing barriers to cannabis research and supporting access to medical cannabis (marijuana) in consultation with the treating physician.